CCTOS Common : Activities
Version 8.1
- Objectives:
- Management and follow up of
activities, here at the top conceptual level.
- Summary:
- Derived from MedicalData.
- Activities have common properties as:
- Agent
responsible of the request. May be different from the author of
the Item.
- Objectives and
motivation of the request:
- Link to
one or several health issues.
- Services as well
intended for diagnoses as well intended for treatments.
- Optional
type of goals (eg diagnostic, treatment, palliative, curative, ...)
- Optional mention of expected results and timing.
- Mission:
- Identification of the type and subtype of requested
activity.
- Content:
- At
this level we are here dealing with a kind of generic place holder.
The details about what is asked will be specified at a lower
level in derived classes, e.g. lab,
X rays, prescription, consultation, request for advice, ...
- Timing of Activities:
- Options
as one shot, or a repeating factor (e.g. once a day), or a conditional
repetition,
- In a time range from a begin to an
end limit.
- With an optional degree of emergency.
- This mechanism is useful for many purposes for
example a
prescription for 3 doses a day during 10 days, as well for a
vaccination every 10 years.
- Work flow
management:
- Status:
Considered, order validated, having an appointment, receptioned, in
progress, draft report, validated report, made available for authorized
users, notified, declared to the administration, declared for
statistics, etc ...
- Worklists:
Worklists provide an overview of what is expected to be done by a given
agent, person or department, for given patients, at given time.
- Selections from worklists:
- Per
center of activity,
- Per status (e.g. waiting for
validation, ....)
- Per patient,
- .....
- If necessary management of
appointments:
- allocation of
time slots in worklist.
- Maintenance of available
times of the diverse resources.
- Management
of requests for activities:
- May be
necessary for several reasons, as the comfort of the patient and the
optimization of the resources.
- A question of
generic interest in various
implementation contexts, as consultations by specialists, admissions,
special examinations.
- In an
integration perspective the idea is that an order
for an Activity must first exist and that planning may be added if
necessary. A standalone appointment system would not make
much
sense.
Planned activities should appear in the presentation of the Care Plan.
- Management can be done in 2 ways:
- As
appointments at fixed reserved times, taking account of the
availability of both the patient and the resources.
- As
items on a waiting list, usually first in first out, and taking account
of urgencies.
- The
actual handling of the activity will be discussed in derived classes,
depending on the specific aspects of the activity.
- There
is here a need for the standardization of requests.
- Moreover the possibility to transfer a request to
an other
external organization.
- Reports:
- In general all activities produce a result in one
way or
an another, although not always recorded, eg a lab test report, a
discharge letter, a note about the evolution of a treatment.
- Again there is also a need of standardization about
how to
share the results of a request.
- several Administration:
- Activities have financial consequences.
- In general all activities must to be declared to the
administration, for billing and statistical purposes.
- Medical
and administrative issues are very different things and should be
handled in different modules.
From the medical point of view, the interface must simply
declare what
has been done, regardless of current price or inclusion in package of
prepaid services.
- Groups
of activities:
- An "activity" may
represent a set of elementary services.
A kind of package including a set of related activities, e.g. an
oncology
treatment requiring a set of services as surgery, radiotherapy,
chemotherapy, etc...
- At this level of a global
"approach", one should pay
particular attention to define objectives and expected results in
relation to a problem.
- "Clinical paths" or more
generally "Care Paths" are standardized set of
activities,
predefined for a typical Health Issue, e.g. hip replacement.
Such
a global
activity may include a set of related activities, which are intended to
be solved as an industrial production center.
However in
reality
many
individual
patients may need adaptations of his care plan, taking account of the
presence of other Health Issues.
- The current "Care Plan" is an
overview of all ongoing activities.
- Specific orders
- Derived from the generic order class.
- many derived classes to be defined here in function of the
various types of orders, among others:
- Request for lab test:
- Which test, on which material, ...
- Request for image, by RX or other imaging technologies:
- Which image, for which reason, ...
- Prescription of drugs:
- Identification of the product and way of use,
duration,...
- Request for advices of a specialist:
- The issue, the question expected to be answered, ...
- Request for admission:
- ....